cognitive behavioral treatment for improving sleep in overweight and obese youth

Conditions: Sleep

Summary: the purpose of this study is to conduct a randomized controlled trial (rct) to evaluate the efficacy of brief cognitive behavioral treatment for child sleep (cbtcs) to improve sleep in an important high-risk population, overweight/obese (ov/ob) youth with behavioral sleep disorders. ov/ob youth with behavioral sleep disorders and their parent(s) will be randomly assigned to 8 sessions of either cbtcs or an educational control (ec). cbtcs will address behavioral sleep issues in children; ec will address sleep and dietary education and general coping strategies. child sleep (total wake time, total sleep time, bed/wake times), height, weight, physical activity, dietary intake, quality of life (qol), fatigue, and daytime sleepiness will be assessed at baseline, post-treatment, and 3-month follow-up. it is hypothesized the children in the cbtcs will experience greater improvement in sleep than children in the ec.

assessment procedures: subjects will participate in 8 treatment sessions and 3 full assessment meetings over the course of 7 months. all meetings will be held at the magnolia park sleep disorders center. the following procedures will be performed: stage 1 - phone screening, stage 2 - screening and baseline measures, stage 3 - overnight sleep monitoring, stage 4 - two weeks wrist actigraphy, sleep diaries, dietary recalls stage 5 - intervention, stage 6 - post-treatment measures, stage 7 - 3-month follow-up

Eligibility criteria:
inclusion criteria: * 6-12 years of age * prepubescent * have a body mass index ≥85th percentile for age and gender norms as published by the cdc, and * accompanied by a parent or legal guardian that lives in the same home as the child. the parent must be able to read and understand english at the 5th grade level. exclusion criteria: * sleep apnea: previous diagnosis or an apnea/hypopnea index (ahi) \>10 according to psg. * periodic limb movement disorder (plmd): previous diagnosis or myoclonus arousals per hour \>5 according to psg. * circadian rhythm sleep disorder, delayed sleep phase type * medication exclusions: prescribed or otc sleep medication within the last 1 month (unless stabilized on medication for 6+ months); currently taking psychostimulants; antipsychotic agents; monoamine oxidase inhibitors; systemic corticosteroids; antibiotics for hiv or tb; chemotherapeutic drugs; or use of prescription weight-loss drugs within six months. * conditions or behaviors likely to affect trial conduct: unwilling to accept random assignment; participation in another randomized research project; parent unable to read and understand english at the 5th grade level; presence of bipolar or seizure disorder (potential sleep restriction); restless leg syndrome, major psychiatric disorder other than anxiety or depression; child with major cognitive or developmental delay; unable to complete forms, implement treatment procedures, etc. due to cognitive impairment; psychotropic or other medications (beta-blockers) known to alter sleep; participation in other cbt treatment or nonpharmacological sleep treatment; or any other condition/situation which would adversely affect trial participation.

Keywords: children sleep obesity